The use of robotics in plastic and reconstructive surgery: A systematic review

Nehme, Jean; Neville, Jonathan; Bahsoun, Ali

doi:10.1016/j.jpra.2017.03.005

Cited by 13 publications

(14 citation statements)

References 42 publications

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“…It provides the surgeon additional comfort and mobility during surgery, and has been demonstrated to improve aesthetic, functional, and quality-of-life outcomes. 16 In addition, it improves visualization, dexterity, and ergonomics for the surgeon. 16 Moreover, scar burden is reduced, as well as postoperative pain and hospital stay.…”

Section: Discussionmentioning

confidence: 99%

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Robotic-Assisted DIEP Flap Harvest for Autologous Breast Reconstruction: A Comparative Feasibility Study on a Cadaveric Model

Manrique

Bustos

Mohan

et al. 2020

J Reconstr Microsurg

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Background The deep inferior epigastric perforator (DIEP) flap is the most common perforator flap for microsurgical breast reconstruction. Contrary to the conventional open approach, robotic-assisted DIEP flap harvest intends to preserve ARS integrity, thereby reducing the morbidity. We assessed the feasibility and compared performance outcomes of a robotic, cadaveric training model for DIEP flap harvest using two approaches: transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP). Methods A robotics system (da Vinci Xi) was applied in conjunction with a cadaveric training model. Ports were placed in the abdominal wall to triangulate each DIEP flap. Surgical time and technical characteristics were recorded. Values were analyzed and compared. Results Eight female cadavers (16 hemi-DIEP flaps) were dissected: 50% TAPP and 50% TEP approaches. Mean harvest time was 56 minutes (range: 48–74 minutes) and 65 minutes (range: 60–83 minutes) for TAPP versus TEP groups, respectively (p < 0.05). Mean pedicle dissection time was 36 minutes (range: 25–40 minutes) and 39 minutes (range: 30–42 minutes) for TAPP versus TEP groups, respectively (p > 0.05). Intra-abdominal contents were manipulated twice on average in the TAPP group versus 0 times in the TEP group (p < 0.05). One TAPP case had an injury to the bowel, and one TEP case was converted to conventional open due to pneumoperitoneum. Conclusion Robotic-assisted DIEP flap harvest represents a technological enhancement for advanced regenerative plastic surgery. Our model demonstrated both TAPP and TEP are feasible, with TEP less invasive, preserving the posterior rectus sheath, and decreasing complication risks. However, there is a steeper and longer learning curve for TEP.

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Section: Discussionmentioning

confidence: 99%

“…16 In addition, it improves visualization, dexterity, and ergonomics for the surgeon. 16 Moreover, scar burden is reduced, as well as postoperative pain and hospital stay. 17 In this robotic-enhanced cadaveric model, we compared performance outcomes of two different approaches for DIEP flap harvest.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted DIEP Flap Harvest for Autologous Breast Reconstruction: A Comparative Feasibility Study on a Cadaveric Model

Manrique

Bustos

Mohan

et al. 2020

J Reconstr Microsurg

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“…3 Pero lo que es un hecho es que los nuevos robots han cambiado su papel en cirugía como ayudantes a ser las manos del primer cirujano a través de una interfase por computadora. 2,7,16…”

Section: Discussionunclassified

“…6 En 2010 se introdujo la disección con robot del músculo dorsal ancho posterior a su investigación en modelos de cadáver. 7…”

Section: Historiaunclassified

Robótica: una nueva rama en cirugía plástica

Oviedo-García¹,

Matabuena-Tamez²,

Canepa-Fernández³

et al. 2021

Cirugía Plástica

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“…Robot-assisted surgery is feasible both for transoral surgery and for neck dissections, and although preliminary reports are positive, further research is required to determine its superiority over conventional approaches. 1 In other anatomical regions, studies are predominately on animals or cadavers: the feasibility of robotic flap harvesting and vascular microanastomosis has been demonstrated, in addition to multiple nerve exploration and repairs. 2 The main barriers to implementation are inadequate instruments (as these are often developed for thoracoabdominal surgery), increased operating times, absence of tactile feedback (although some argue that three-dimensional visualization makes up for this), and high costs and space requirements.…”

mentioning

confidence: 99%

Interventional Technology in Plastic and Reconstructive Surgery

Sanchez-Thompson

2021

Plastic &Amp; Reconstructive Surgery

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Volume 148, Number 3 • Viewpoints 523e navigation. Probably the most extensive use of virtual reality is in training. Immersive work benches for orthographic maxillofacial surgery have been described by multiple authors, but to date, plastic surgery-specific workbenches are lacking.Near-infrared fluorescence image guidance aims to help with intraoperative navigation through highlighting blood vessels, lymphatics, and ureters, even when obscured by thin layers of other tissues. 5 The main limitations are the penetration depth, which is usually limited to 1 to 1.5 cm. Current researchers are looking at developing a wider array of dyes, including tagging of adipose tissue, lymphatics, and nerves. This is exciting new technology, but further research is required.Despite the exciting innovations occurring in interventional technology and imaging, these have only infiltrated the world of plastic and reconstructive surgery on a very small scale. These technologies require large investments, and plastic surgery is hampered by the lack of transferability in many of these technologies, and a lack of evidence to promote their use. However, all technologies discussed have proven feasible, and plastic surgery will continue to benefit on a small scale from innovation across other surgical specialties. If high evidence-based benefits can be proven, manufacturers and researchers may be persuaded to invest time and money into this barely penetrated market.

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The use of robotics in plastic and reconstructive surgery: A systematic review

Cited by 13 publications

References 42 publications

Robotic-Assisted DIEP Flap Harvest for Autologous Breast Reconstruction: A Comparative Feasibility Study on a Cadaveric Model

Robotic-Assisted DIEP Flap Harvest for Autologous Breast Reconstruction: A Comparative Feasibility Study on a Cadaveric Model

Robótica: una nueva rama en cirugía plástica

Interventional Technology in Plastic and Reconstructive Surgery

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